Pennsylvania orders Hahnemann University Hospital to ‘cease and desist’ closure until there’s a plan
The cease and desist order steps up the tension between Hahnemann officials and state and city regulators.
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A face-off between state officials and the owner of Hahnemann University Hospital over the short-term future of the Center City institution sharpened Thursday.
The Pennsylvania Department of Health ordered the owner of Hahnemann University Hospital to not take any action toward the closure of Hahnemann until regulators approve a plan that ensures “the safety of those persons who are reliant on the care provided by Hahnemann.”
Meanwhile, Hahnemann’s warning that it will cease operations and put 2,572 hospital employees out of work by early September arrived in Harrisburg. The layoff notice was dated Tuesday.
The “cease and desist” letter from state Secretary of Health Rachel Levine said the department had concluded that “an immediate closure of Hahnemann or the termination of any services” “may cause irreparable harm to the health and safety of patients” in Philadelphia, especially during the Fourth of July holiday week.
If the 496-bed Hahnemann closes as announced by September, it will be the second hospital that serves large numbers of poor and indigent patients to do so in recent years. The 146-bed St. Joseph’s Hospital, in North Philadelphia closed in March 2016 after state officials pulled a special subsidy that had kept it open.
Hospitals like Hahnemann and St. Joseph’s, with a large portion of their patients on Medicaid, have a hard time eking out a profit because the government insurance for the poor does not pay enough to cover costs, experts say.
Hahnemann officials had little to say Thursday in reaction to the regulators’ action: “We acknowledge receipt of the [Department of Health] letter, and as we have said from the start, we intend to conduct the closure in an orderly manner that prioritizes the health care needs of our patients.”
Hahnemann’s closure would mark the end of a short but turbulent chapter in the long history of the hospital, which traces its roots to a homeopathic medical college that opened in 1848.
A California investment banker, Joel Freedman, bought Hahnemann and St. Christopher’s Hospital for Children early last year from Tenet Healthcare Corp. for $170 million, but found the financial condition of Hahnemann, in particular, much worse than expected. He said in April that the hospital was losing $3 million to $5 million a month and could not stay open if he didn’t get help from the state and better rates from commercial insurers.
Going to Hahnemann
For Emergencies,
But Little Else
Hahnemann University Hospital had more than 15,000 inpatient admissions from emergency-room visits in 2017, the fifth-highest total among major Philadelphia hospitals. But Hahnemann struggled to attract admissions from other sources, totaling less than a tenth of the non-ER admissions compared with hospitals affiliated with Jefferson, Temple, or the University of Pennsylvania.
1
9
5*
4
95
5*
N
2
MILES
1
Hahnemann
0
2
8
7
1
Chart only includes hospitals identified by state data as having comprehensive ER units, and exclude children’s hospitals. Circle sizes are proportional to total visits in 2017.
3
6
76
95
Total inpatient
admissions
in 2017
Inpatient admissions from
ER visits
Non-ER
Hospital
1
Jefferson University Hosp.
39,973
18,714
21,259
2
Temple University Hosp.
35,009
15,683
19,326
3
34,820
Hosp. of the Univ. of Pa.
12,355
22,465
4
Einstein Medical Center
24,962
16,281
8,681
5
Jefferson Health-Northeast*
23,342
20,267
3,075
6
Pennsylvania Hospital
18,569
5,918
12,651
7
Hahnemann University Hosp.
17,179
15,572
1,607
8
16,807
Penn Presbyterian Med. Ctr.
9,299
7,508
9
Chestnut Hill Hospital
7,360
6,504
856
* Includes Jefferson Torresdale, Frankford, and Bucks Hospitals
SOURCE: Pennsylvania Department of Health
JOHN DUCHNESKIE / Staff Artist
Going to Hahnemann for
Emergencies, But Little Else
Hahnemann University Hospital had more than 15,000 inpatient admissions from emergency-room visits in 2017, the fifth-highest total among major Philadelphia hospitals.
But Hahnemann struggled to attract admissions from other sources, totaling less than a tenth of the non-ER admissions compared with hospitals affiliated with Jefferson, Temple, or the University of Pennsylvania.
1
9
5*
4
95
N
5*
MILES
2
1
0
2
Hahnemann
8
7
1
Chart only includes hospitals identified by state data as having comprehensive ER units, and exclude children’s hospitals. Circle sizes are proportional to total visits in 2017.
3
6
76
95
Inpatient admissions in 2017
Hospital
Non-ER
ER visits
Jefferson
Univ. Hosp.
18,714
21,259
1
Temple
Univ. Hosp.
15,683
19,326
2
Hosp. of the
Univ. of Pa.
12,355
22,465
3
Einstein
Medical Ctr.
4
16,281
8,681
Jeff. Health-
Northeast
5
20,267
3,075
Pennsylvania
Hospital
6
5,918
12,651
Hahnemann
Univ. Hosp.
15,572
1,607
7
Penn
Presbyterian
8
9,299
7,508
Chestnut Hill
Hospital
6,504
856
9
* Includes Jefferson Torresdale, Frankford, and Bucks Hospitals
SOURCE: Pennsylvania Department of Health
JOHN DUCHNESKIE / Staff Artist
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After months of talks with state officials failed to result in a deal that could keep Hahnemann open, Freedman, who owns the hospital through a series of holding companies, announced Tuesday that the hospital would close “on or about Sept. 6.”
That closure date would violate a 90-day notice requirement before a hospital can be closed. The state’s cease-and-desist order also says that regulators must approve a closure plan before it can be put into effect.
If Hahnemann moves forward with closure plans before getting approval, it could be fined and face legal action, the Health Department said. July Fourth loomed large for city and state officials.
“If Hahnemann or any part of the facility closes before the upcoming July 4 holiday, it could have wide-spread effects on the city,” the cease-and-desist letter said.
Hahnemann had been planning to start diverting trauma cases from its emergency room on Monday. The hospital recorded about 53,000 emergency-room visits in 2017, according to the most recent data available.
City officials said Wednesday in a letter to Freedman that the plan was unacceptable on such short notice.
“This is the beginning of Fourth of July week, which in Philadelphia typically coincides with elevated levels of emergency transports,” the city’s letter said.
The city on Thursday did not provide data to back up that assertion.
The cease-and-desist order was welcomed by union leaders but falls far short of the long-term financial lifeline called for by Hahnemann registered nurses represented by the Pennsylvania Association of Staff Nurses and Allied Professionals, who rallied Thursday at City Hall, holding signs like “The Safety Net Is Not Optional,” “Save Our Hospital,” and “Patients Over Profits.”
“We care for some of the sickest people in the city and the state,” oncology nurse Dylan Toolajian told the crowd. Toolajian recounted how at work Wednesday, while he was sitting at the nurses’ station absorbing the news of the closure, a former patient visited to tell staff that he will never forget the care he got at Hahnemann.
Chris Woods, executive vice president of District 1199C of the National Union of Hospital and Health Care Employees, which represents 375 nurses aids, cleaners, patient transporters, and others at Hahnemann, said he was grateful for the state action preventing an abrupt closure.
“We hope that now real discussions can begin about strategies to save Hahnemann Hospital permanently,” he said.